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Can You Be Mentally Healthy and Hurting?

Let’s say that you’ve done a lot of personality work, growth work, and healing work on yourself and you feel that emotionally you’re in pretty good shape. Then something unfortunate happens. You’re hit with an episode of sadness, an incident of anxiety, a period of overwhelm, a stint of confusion, a bout of malaise, a meaning crisis, a week of upset. As much work as we do on ourselves, these events still do happen.

These emotional changes make themselves felt in very powerful and painful ways, just as a broken leg or a severe rash would. But with emotional upheavals of this sort we typically do a funny thing. We let the incident define us. We don’t “have a bout of sadness,” we “are depressed.” We completely identify with the problem. With a rash we say, “I have a rash,” not “I am a rash.” With an episode of sadness we do the exact opposite. We say, “I am depressed” instead of “I have sadness.” This is a huge difference and a huge problem.

Our current model of mental health and mental illness prevents us from speaking subtly or correctly about human emotional states. It misleads us on purpose into believing that when we experience emotional pain we have become “mentally ill.” The truth is quite different. We may be essentially mentally healthy but dealing with a profound emotional problem, just as we may be essentially physically healthy but dealing with a broken leg or a severe rash. “I am mentally healthy but currently experiencing emotional pain” is a very different reality from “I have the mental disorder of depression.”

It is certainly the case that the itchy rash may be the only thing on our mind. Still we do not choose to have it define us. We know that it would be a fundamental mistake and misunderstanding to say, “I am rash.” The sadness may likewise be the only thing on our mind and yet here we find it easy, and maybe even convenient, to say, “I am depressed.” It is almost as if we want to distance ourselves from the possibility that this sadness is caused by something that we might need to address.

Consider the following example. Picture someone who is deeply upset in an ongoing way because the actions of her youth have resulted in her inability to have children. She continues to grieve that loss, she continues to feel guilty about her part in the situation, and she continues to feel angry about how society and the people around her, including family members, contributed to her current reality. She is very strong and very healthy in many ways but this particular pain is never-ending.

In a real way this grief colors her days and makes her sadder (called “depression” in the inaccurate parlance of the medical model mental health industry) than she otherwise would be. At the same time she manifests emotional strength in all sorts of ways and actually feels good, except for this sadness. As it turns out, and really strangely enough, we do not have a way to talk about emotional situations of this sort. With physical problems we use language to make exactly these sorts of distinctions and with emotional problems we do not.

With physical problems we say, “I’m feeling just fine except that I’m dealing with a broken arm.” We say, “My health has never been better but this allergy season is killing me!” We say, “I am bothered by a chronic neck ache from sitting at the computer for so many hours each day and I’m doing exercises to help with that but otherwise I feel just fine.” That is, with physical ailments we have a way of distinguishing a particular problem from our general state of being. With emotional states we don’t.

We are not accustomed to saying and don’t seem to want to say, “I am feeling emotionally very well except that I am currently sad.” We are not accustomed to saying and don’t seem to want to say, “I am feeling emotionally very well but I still get anxious when I think about flying.” In the first instance we say “I’m depressed” and in the second instance we say “I’m phobic,” perhaps not quite realizing what a disservice we are doing ourselves by characterizing ourselves in such globally disabled ways.

By saying “I’m depressed,” “I’m attention deficit disordered,” “I’m phobic,” “I’m anxious,” and so on, we not only do a poor job of honoring our wellness but we may completely forget about that wellness and begin to see ourselves as essentially not well, as opposed to essentially well but burdened by issues that need attention. Yes, it is odd and cumbersome to say “I am sad but essentially well” or “I am anxious but essentially well” but if that is the truth, if in fact we are emotionally in pretty good shape except for some current sadness or some current anxiety, then it pays us to honor that reality and remind ourselves of the well part as well as the current difficulty.

This odd, cumbersome but truthful way of speaking to yourself will help remind you that this is quite likely a passing event (though of course it may be very painful and though of course it may reoccur) and that, as a real but passing event like a broken arm or a case of poison ivy it must be addressed. If, for example, this episode of sadness is being caused by your sense that neither you nor your efforts matter, if, that is, you are experiencing a meaning crisis and an episode of existential sadness, then that must be addressed. It will not pay you to just mouth the words, “I am depressed.”

It is possible to envision many varieties of mental health that mirror more closely how people actually live and actually feel. The one I’ve just described, of a woman plagued by regrets and sadness about her infertility but who is also emotionally healthy and strong, we might call “healthy but in recurring emotional pain.” This is as much a state of health as it is of illness. Her basic emotional strength must be honored just as her enduring pain must be addressed. She is not “mentally ill,” she is a healthy person in real pain. There is a difference!

There are many such varieties of mental health, where a person is essentially healthy but also really troubled. For example there is the following one: “Sad and not sad at the same time.” Let’s look at that variety of mental health in our next installment.

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Eric Maisel, Ph.D., is the author of more than 40 books including the forthcoming Making Your Creative Mark (New World Library, 2013) and Why Smart People Hurt (Conari Press, 2013). Widely regarded as America’s foremost creativity coach, Dr. Maisel founded natural psychology and leads workshops nationally and internationally. You can learn more about Dr. Maisel’s books, services, trainings, and workshops at http://www.ericmaisel.com. You can learn more about natural psychology at http://www.naturalpsychology.net. Dr. Maisel can be reached at ericmaisel@hotmail.com.

I have been dealing with a chronic injury for years, but other than that and some allergies, I am healthy. It has never even occurred to me to describe myself as unhealthy on the days my knee hurts and I feel a bout of sinus congestion coming on. Those are things I deal with but would never define myself by.

I'll remember that the next time I describe myself as "depressed" or having "depression" simply because I don't like my job but am otherwise satisfied with life.

I probably would never have come to call myself depressed if my primary care doctor had not labeled me that way...

If a person considered themselves well but had a loved one die, and experienced no sadness, that would strike most people as a serious warning flag. If they experience the expected sadness, they're "depressed". This is not the only area in life in which people get labeled by opposite extremes; if you are sexual, you're a "slut", and if you're not, you're a "prude"; if you're assertive, you're a "control freak", and if you're not, you're a sap. I don't know if it's the influence of sensationalizing media, or what, but we don't seem to allow for a healthy middle ground on much of anything.

Last winter, I was fired from my job for being "unhappy" as a long-term contractor who had been promised something better nearly a year and a half before. I was lucky to find another job very quickly, but that lingering sense of shame and embarrasment persisted, and I went through a period of probably three months of sadness. As I described it to my husband, I just felt like all my armor had been stripped away, like a fragile baby bird who couldn't quite stand to be out in the world more than I needed to.

What's interesting is that everyone told me I was depressed. Having actually be quite severely depressed in my teenage years, I'm always pretty hyper-vigilant about examining how I feel. I have no desire to go back on medication, so I feel like if I can catch myself before I really feel that sense of hopelessness and despair, I can get help in CBT before resorting back to pills.

But nobody said, hey, this is normal. Hey, you just experienced a traumatic life event that totally shook up your sense of life. Hey, it's probably pretty common that you feel freaked out and don't have a whole lot of energy for socializing, and choose instead to stay inside and take care of yourself.

This is going to sound silly, but one way I dealt with these feelings was to remind myself of everything you said - only, my touchstone for this kind of thing is to imagine what a French person would do. I've had some great talks with a French coworker about the way they have different expectations of life. When someone asks you how you are in France, you're not expected to just say "fine." And if you DO say, "Eh, not great," nobody tries to fix it. You're allowed to just BE glum sometimes, because sadness is a part of life.

So that's what I thought about. That sadness was just a part of life sometimes and that it would pass, sooner or later, and all I had to do was sit with it, keep it company, and let it do whatever it was in my life to do. And it worked.

I just had that happen! I'm not a receptionist or anything, don't deal with the customers, but I got fired for violating the unwritten "smile or die" rule that my employer wouldn't admit to. Like you, I've spent three months being alternately humiliated and angry, because I moved here specifically for the job and have no other reason to be here.....and this place SUCKS for finding a new job. There simply aren't any.

Rather than go through what Joyce above me mentions, I'm just keeping to myself so I don't have to fake happiness for the comfort of others.

I hate when other people think you should be happy when you're hurting. Other than that, I'd be fine. I'm "as well as can be under the circumstances" but I'm allowed to not have to be "happy". You feel how you feel. It is possible to feel sad, stressed, etc. and still cope, as long as people aren't making it worse by telling you you shouldn't feel that way.